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R826

R826Resection of AV aneurysm or fistula with or without major graft - minor aneurysm

OHIP Radiology Code — CARDIOVASCULAR SURGICAL PROCEDURES · Schedule of Benefits

Resection of a minor arteriovenous (AV) aneurysm or fistula, with or without a major graft. As a surgical procedure, it is eligible for surgeon (A), assistant (B), and anaesthetist (C) claims. The fee for assistant and anaesthetist services is calculated based on basic units plus time-based units.

When to Use

  • Use R826 for the surgical resection of a minor, non-haemodialysis-related AV aneurysm or fistula.
  • Select R826 when the procedure involves the excision of a peripheral AV fistula or aneurysm that does not fall under the specific haemodialysis revision codes found in section J38.

Common Pitfalls

  • Billing R826 for the revision or repair of an AV fistula or graft specifically used for haemodialysis will result in a rejection, as these are restricted per the Schedule of Benefits.
  • Failure to append the correct suffix (B for assistants, C for anaesthetists) will cause the associated professional fees to be rejected or processed incorrectly.

Billing Tips

  • Ensure the operative report clearly distinguishes the procedure as a resection of a minor aneurysm or fistula to justify the use of R826 over more complex cardiovascular codes.
  • When billing after-hours, verify the procedure start time against the specific E-code requirements (E400/E401 series) to ensure the appropriate percentage premium is applied to the base fee.
Provider Fee$497.25
Surgical Assistant Fee$125.10
Anaesthetist Fee$154.90
Non-Anaesthetist Fee$154.90

Effective: April 1, 2025

Category

Q. Cardiovascular Surgical Procedures

Subcategory

CARDIOVASCULAR SURGICAL PROCEDURES

Service Type

Surgical

Code Classes

Cardiovascular Surgical Procedures

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